Catalina Beginning Swim Lessons
These lessons are open to Catalina Swim Club members or grand kids of members only. All lessons will take place in the junior pool area. Parents will be allowed to assist, if they want, with swimmers who are not comfortable being in the water. Jason and other guards will help the swimmers get more comfortable in the water, and begin doing the first levels of swim lessons. After filling out this form, you will receive an email, with confirmation of your submission. Jason Kubick will also be sending out confirmation he has received it, along with how to pay, in the week before swim lessons. If you have any questions about lessons, please email Jason Kubick at, NOT the pool. Thank you for your interest in the beginning swim lessons!
Sign in to Google to save your progress. Learn more
Email *
Which session would you like to put your swimmer in? *
Parent(s) Name *
Phone # *
Alternate Phone #
Alternate Email
Family Membership *
Name of Swimmer 1 *
Age of Swimmer 1 *
Name of Swimmer 2
Age of Swimmer 2
Emergency contact during swim lessons
Emergency contact phone #
I, the parent or guardian, hereby authorize my child or children listed above to participate in the Catalina Swim Club swim lessons for the summer of 2019, and hereby forever release and discharge the Catalina Swim Club and its representatives from any suit, judgment, injury, claim, or demand which might result from the participation of said child(ren) in the Catalina Swim Lessons. *
I, the parent or guardian, authorize the Catalina Swim Club staff to obtain emergency medical treatment for my child(ren) in the event I cannot be located and authorize providers of medical care to effect such treatment as may be necessary in their judgment for care. *
I, the parent or guardian, give the Catalina Swim Club consent to post my child(ren) in pictures, videos, or other forms of media, posted on the Catalina website, Facebook, Twitter, or Instagram pages. *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy